We wish we had been wrong on this one — for the sake of the health and well-being of adolescents across the country. We are sad to say that Ascend was right.
Ever since President Obama’s 2010 budget eliminated all federal funding for Sexual Risk Avoidance (SRA) education to create the Teen Pregnancy Prevention (TPP) program, advocates assured that curricula on the TPP approved curricula list were proven effective. HHS posted the promise for positive results on its own website. Communities believed the promise. Schools believed. Parents believed. Policymakers believed. Youth bore the reality.
Repeatedly, from the start, and at the highest levels, Ascend urged those who had the ability to correct these false, exaggerated, and overzealous promises to do so. Our overriding concern was echoed by a researcher interviewed for the Association of Planned Parenthood Leaders in Education.
To ensure that students were not hurt by the TPP program, Ascend stressed the importance of following important research protocols for program criteria. Instead, program administrators ignored basic protocols that clearly warn against overgeneralizing results. They implied curricula on the HHS list were national models, ignoring the standard that at least two positive replications are needed to make such a claim.
They also failed to account for conflict of interest concerns for those who conducted the research. Financial or intellectual conflicts of interest can compromise research, especially when one’s program earns a coveted spot on a government-approved list that promises communities positive results if these curricula are implemented.
Caution is warranted when 75 percent of all curricula on the HHS list were evaluated, not by independent researchers, but by the program developer or publisher. One developer is responsible for the research of 8 curricula on the list. The monetary windfall inherent in such a practice gives new meaning to gold standard research.
In addition, curricula were added to the TPP evidence-based list whose results didn’t reduce students’ risk. For example, rather than measuring correct and consistent condom use, numerous studies only reported increased condom use or condom use at last intercourse – measures that research indicates may not decrease risk – and which could actually increase risk. In addition, a review of findings indicates that curricula remained on the list even when it was clear that replications made students more likely to engage in risky sexual practices.
We were alarmed that these warning signs were ignored. We were concerned that teens might be harmed as a result. Ascend’s recommendations were ignored and the effusive narrative continued by those who should have known better.
Now, nearly one billion dollars later, troubling revelations have surfaced that show that most youth did not improve their health as a result of the TPP program — and too many were hurt. Multiple studies, mostly from federal sources, paint a stark picture of the results of this one-billion-dollar experiment:
More than 80 percent of teens in the program fared either worse or no better than their peers who were not a part of the program, findings of HHS reveal.
Sex promotion rather than health promotion
Students were harmed by the TPP program. Some teens who were taught the TPP program were more likely to get pregnant, more likely to have sex, and more likely to have oral sex. A cursory look at a current TPP grantee makes the case for why this might be true. The NC Shift organization holds two TPP grants for almost $12.5 million. Incredulously, they send youth as young as eleven to sites that normalize sex. It is no surprise, then, that teens feel more pressured to have sex from their sex ed classes than they do from their dating partners.
Communities don’t want it
Not unexpectedly, then, fewer communities currently implement sex education programs with contraceptive instruction. More communities choose SRA education, despite very limited funding. Another recent survey of confirms that most Americans (Republican and Democrat) prefer the way SRA programs share information and skills with youth.
Less likely to use contraception
Contraceptive advocacy, demonstration, and distribution, are cornerstones of most TPP grants Yet the CDC reports that since the TPP program began, sexually active teens are increasingly less interested in using contraception.
In fact, sexually active students in 2009 (at the conclusion of the Bush Administration) were more likely to use a condom or birth control pills than in 2015 — 5 years into the TPP program.
Though more are using long acting reversible contraception (LARC), fewer teens also use a condom, a requirement to reduce the risk of acquiring an STD.
More likely to acquire an STD
Most teens are not having sex, but those who are, are at great risk, especially for STDs. The CDC reports that combined cases of STDs are at their highest levels — and young adults are at greatest risk, accounting for nearly 2/3 of all reported cases of chlamydia and gonorrhea, though they only comprise twenty-five-percent of the sexually active population.
In the case of sex education, where giving youth the information and skills that result in their optimal health should take public health precedence, Maya Angelou’s famous quote is fitting: “When you know better, do better.”
While perhaps well-intentioned at its inception, the ongoing vigorous defense of the TPP program is vapid at best. The stats confirm that the TPP program is a colossal waste of taxpayer dollars. But worse than that, most teens are not helped, and too many are harmed. We must do better.
Valerie Huber is the president and CEO of Ascend, an organization that represents the field of Sexual Risk Avoidance education. Having previously worked in the public health field, Huber supports SRA education as an optimal health strategy to improve opportunities and future prospects of America’s youth.
The views expressed by contributors are their own and are not the views of The Hill.